The 532 nm pulsed KTP (potassium titanyl phosphate) laser and the 585 nm pulsed dye laser (PDL) are photoangiolytic lasers that have been demonstrated to be effective for managing vocal fold dysplasia. The putative mechanism of action is selective photoangiolysis of the sublesional microcirculation. On the basis of this experience, early glottic cancers were treated by selectively targeting the intralesional and sublesional microvasculature. This approach was derived from Folkman's concepts of neoplastic growth resulting from tumor angiogenesis. Staged microlaryngeal treatment was adopted, because it facilitated optimal functional results, and was considered safe, because early glottic cancer rarely metastasizes. Furthermore, intercurrent disease during conventional incremental radiotherapy is typical in treating early glottic cancer. A pilot group of 22 patients with early glottic cancer (13 T1, 9 T2) were treated with a fiber-based angiolytic laser. Eleven of the 22 had unilateral disease and were entirely treated by laser photoangiolysis as a sole modality. Eleven of the 22 had bilateral disease; 5 of the 11 were treated entirely (bilaterally) by laser photoangiolysis, and 6 of the 11 only underwent laser treatment of the less involved vocal fold, with conventional resection being done on the dominant side of the cancer. The initial 8 of the 22 were treated with the PDL, and the latter 14 of the 22 were treated with the pulsed KTP laser. No patient has cancer presently, and none have undergone posttreatment radiotherapy or open surgery. The mean follow-up is 27 months, 13 of the 22 patients have at least 2 years of follow-up, and the first patient was treated just over 5 years ago. Objective measures of vocal function revealed that photoangiolytic treatment of early glottic cancer resulted in significant postoperative improvements despite the fact that half of the patients had bilateral disease. Angiolytic lasers effectively involuted early glottic cancer, with microsurgically directed nonionizing radiation of the dense neoplastic blood supply resulting in complete tumor regression. This approach is conceptually attractive, because it is repeatable, it preserves all conventional cancer treatment options, and it results in excellent vocal function by improving phonatory mucosal wave vibration. Observations from this investigation suggest that this new and novel cancer treatment strategy is effective; however, larger patient cohorts, longer follow-up, and multi-institutional confirmation will be necessary to establish incontrovertible oncological efficacy.
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http://dx.doi.org/10.1177/00034894081170s701 | DOI Listing |
Iran J Otorhinolaryngol
January 2025
Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, University of Sousse, Sousse, 4000, Tunisia.
Introduction: Frontal anterior laryngectomy with epiglottic reconstruction (Tucker's reconstructive surgery) is a technique of partial laryngectomy that has been used by several authors since its introduction in the 80s.The aim of this serie is to specify the indications of this operation and to present the functional and oncological outcomes of our study and those found in the literature.
Materials And Methods: We report a retrospective study of 65 cases who underwent Tucker's operation by many surgeons at our educational center over a period of 31 years (1988 - 2020).
BMJ Case Rep
January 2025
Department of Otolaryngology, Albany Medical College, Albany, New York, USA.
Subglottic cysts and hemangiomas are rare but potentially life-threatening conditions in pediatric patients. Subglottic cysts are generally associated with premature infants with a history of prolonged endotracheal intubation, while subglottic hemangiomas are congenital vascular lesions that grow rapidly and are uncommon head and neck tumours in pediatric patients. Both conditions can present with generalised respiratory symptoms such as stridor.
View Article and Find Full Text PDFHead Neck
January 2025
Department of Radiation Oncology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Objectives: We aimed to compare the outcomes of patients with T1-T2N0M0 glottic squamous cell carcinoma who underwent either partial laryngectomy (PL) or radiotherapy (RT).
Methods: A retrospective analysis of 562 patients treated with RT (n = 151) or PL (n = 411) was conducted. The Kaplan-Meier method was used to estimate outcomes.
Laryngoscope
January 2025
Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, U.S.A.
Objective: To identify the most effective treatment modality for achieving favorable outcomes in early glottic tumors with anterior commissure involvement (ACI).
Data Sources: PubMed, Embase, Web of Science, and ScienceDirect.
Review Methods: Random-effects proportional meta-analysis model is used to evaluate the oncological and functional outcomes of transoral laser microsurgery (TLM) versus radiation therapy (RT) in early glottic (T1-T2) cancer with ACI.
Acta Otolaryngol
January 2025
Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China.
Background: The early diagnosis of glottic laryngeal cancer is the key to successful treatment, and machine learning (ML) combined with narrow-band imaging (NBI) laryngoscopy provides a new idea for the early diagnosis of glottic laryngeal cancer.
Objective: To explore the clinical applicability of the diagnosis of early glottic cancer based on ML combined with NBI.
Material And Methods: A retrospective study was conducted on 200 patients diagnosed with laryngeal mass, and the general clinical characteristics and pathological results of the patients were collected.
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